Early determinants of childhood obesity: Etiology disparities policy analysis

项目摘要 到5岁时，超过10%的美国儿童肥胖，少数民族儿童和更多儿童肥胖。 弱势群体受到的影响尤为严重。虽然有证据表明， 妊娠和早期生活与儿童肥胖相关，观察性研究中存在潜在混杂因素 小的、有限的样本对推断因果关系提出了挑战。关于在多大程度上 这些关系适用于所有种族/族裔群体。为支持健康行为而制定的政策实际上 如果只由来自某些种族/族裔的母亲收养，肥胖风险因素的差异就会增加。 组或多组。很少有研究涉及这一问题。此次K99/R 00奖励将 为PI提供机会，以建立她在流行病学方面的背景，并获得因果关系方面的培训 推理，政策评估，并通过正式的课程和导师将研究转化为政策 跨学科的著名学者团体。这个K奖的首要目标是澄清 儿童肥胖差异的产后风险因素，并研究政策对儿童肥胖差异的影响。 这些风险因素。这项研究计划将推动肥胖预防领域的最大化， 通过数据连接利用公共数据，将经济学和流行病学的分析技术结合起来， 推断因果关系，了解对种族/民族和社会经济差异的影响，并确定政策 行为改变的驱动因素。PI将通过链接马萨诸塞州的出生情况，创建一个包含215，000名儿童的数据集 将证书数据输入健康儿童访问的电子数据库。在奖学金的辅导阶段（K99）， PI将检查孕妇在怀孕期间吸烟、妊娠期体重过度增加和 以及检查这些风险因素与肥胖相关结果之间的关联 在2岁和5岁的时候。在授予的独立阶段（R 00），PI将检查以下因素的影响： 关于这些风险因素的普遍性以及种族/族裔和社会经济差异的政策，重点是 烟草控制政策和妊娠期体重增加建议的最新变化。政策和 马萨诸塞州和全国的儿童早期肥胖预防计划将被评估， 确定怀孕和生命早期的因素在多大程度上被包括在内。PI将介绍 这项研究计划的结果将提供给州政府的政策制定者，并帮助确定未来的发展领域。 肥胖预防策略。PI将在奖励的第四年提交R 01申请， 继续追求这些方法和跨学科的合作，以推动 关于妇幼保健差距的研究议程。

Project Summary By age 5, more than 10% of US children are obese and children from ethnic minority groups and more disadvantaged circumstances are disproportionately affected. While evidence exists that risk factors during pregnancy and early life are associated with childhood obesity, potential confounding in observational studies and small, restricted samples present challenges to infer causation. There is debate about the extent to which these relationships apply to all racial/ethnic groups. Policies enacted to support healthy behaviors may actually increase disparities in the risk factors for obesity if they are adopted only by mothers from certain racial/ethnic groups or more advantaged groups. Few studies have addressed this concern. This K99/R00 award will provide an opportunity for the PI to build on her background in epidemiology and acquire training in causal inference, policy evaluation, and translating research into policy through formal courses and mentorship by an interdisciplinary group of renowned scholars. The overarching goals of this K award are to clarify peri- and post-natal risk factors for disparities in childhood obesity and to examine the effects of policies on disparities in these risk factors. This program of research will move forward the field of obesity prevention by maximizing the utility of public data through data linkage, integrating analytic techniques from economics and epidemiology to infer causality, understanding influences on racial/ethnic and socioeconomic disparities, and identifying policy drivers for behavior change. The PI will create a dataset of 215,000 children by linking Massachusetts birth certificate data to an electronic database of well-child visits. During the mentored phase of the award (K99), the PI will examine disparities in maternal smoking during pregnancy, excessive gestational weight gain, and breastfeeding as well as examine the associations between these risk factors and adiposity-related outcomes at ages 2 and 5 years. During the independent phase of the award (R00), the PI will examine the influence of policies on the prevalence and racial/ethnic and socioeconomic disparities in these risk factors, focusing on recent changes in tobacco control policies and gestational weight gain recommendations. Policies and programs for early childhood obesity prevention both in Massachusetts and nationally will be assessed to determine the extent to which factors during pregnancy and early life are included. The PI will present the findings from this program of research to policy makers in state government and help identify areas for future obesity prevention strategies. The PI will submit an R01 application during the fourth year of the award to continue to pursue these methods and interdisciplinary collaborations with the aim of pushing forward the research agenda on disparities in maternal and child health.